The term "Innate Intelligence" (sometimes abbreviated "II") is still used by certain chiropractors. At Palmer College of Chiropractic the definition of Chiropractic states, "Chiropractic philosophy begins with the principle that the human organism has an innate power to maintain its own health" and includes "This unique health care approach views the body as having an innate, natural ability to adapt to changes in its internal and external environments and maintain itself in a state of health."[2]

The term "Innate Intelligence" (sometimes abbreviated "II") is still used by certain chiropractors. At Palmer College of Chiropractic the definition of Chiropractic states, "Chiropractic philosophy begins with the principle that the human organism has an innate power to maintain its own health" and includes "This unique health care approach views the body as having an innate, natural ability to adapt to changes in its internal and external environments and maintain itself in a state of health."[2]

wow sure sounds like homeostasis to me

There's nothing wrong with using that type of teleology to describe the way the body deals with it's problems and heals itself. It resembles an intelligent mind in the way it functions.

In a similar way, an evolutionist may say that a particular adaptation "is designed to..." but in no way is that person actually endorsing Intelligent Design. It's simply a good way of describing a process in the context of it's end result.

The job of a skeptic is to investigate the unexplained; not to explain the uninvestigated.

so you want me to prove that homeostasis and innate intelligence are the same thing?

ever hear of google?

as far as the other comment... you are really good at changing the subject. my point was that S. Barrett appears to be touched in the head when you research him. why does this board and you hold him in such high esteem? that was the question.

and if he is generally a flawed person who has been discredited on numerous occasions - why hold his work to be anything more than a reflection of his flawed personality. any normal person reads quackwatch as a propoganda web site pushing his point of view. this is something that you complain about others doing.

do i want to waste my time going point by point and citation by citation looking for misrepresentations - I don't know about you but i have a life and i really could care less if i meet up with your standards

how vague is "substantially wrong" - obviously you already know there is problems on that site for you to say that

Cervicogenic vertigo is caused by functional disorders of the craniovertebral joints. Improvement of vertigonous symptoms by chiropractic treatment was often described. The therapeutic effect of chiropractic treatment in 28 patients with vertigo and purely functional disorders of the upper cervical spine or with a combination of functional disorders of the upper cervical spine and the labyrinth was evaluated. Improvement of vertigonous symptoms on patients with purely functional disorders of the craniovertebral joints as well as on patients with combined functional disorders of the craniovertebral joints and labyrinth could be seen. Two of the 28 patients showed persistent relief of symptoms and normalisation of cervical motility whereas the vestibular deficit persisted. One patient with persistent vestibular dysfunction showed recurrent malfunction of the upper cervical spine and vertigo. In our opinion chiropractic treatment is mandatory for the therapy of patients with vestibular affections and functional disorders of the craniovertebral joints.

The term "Innate Intelligence" (sometimes abbreviated "II") is still used by certain chiropractors. At Palmer College of Chiropractic the definition of Chiropractic states, "Chiropractic philosophy begins with the principle that the human organism has an innate power to maintain its own health" and includes "This unique health care approach views the body as having an innate, natural ability to adapt to changes in its internal and external environments and maintain itself in a state of health."[2]

wow sure sounds like homeostasis to me

There's nothing wrong with using that type of teleology to describe the way the body deals with it's problems and heals itself. It resembles an intelligent mind in the way it functions.

In a similar way, an evolutionist may say that a particular adaptation "is designed to..." but in no way is that person actually endorsing Intelligent Design. It's simply a good way of describing a process in the context of it's end result.

I disagree. As these examples show, the specific definition of "innate intelligence" as used by chiropractors ignores what we do know about biology in favor of a "know nothing", profoundly non-medical approach that serves to keep patients uninformed.

You see, Ronald, that your attempt to cite reliable literature fails again. What don't you understand about large (not 28 subjects), randomly assigned, controlled, blinded research? Oh, I know- you are a member of a cult that believes whatever you read or are told, no matter how feeble it is. You did not say what that article was meant to illustrate, to me it shows how poor your education is if you would cite it as anything other than crap. In the past, chiros have sued their schools for inferior teaching; but they lost because the school did not promise (contractually) a good education.

JJM wrote:So, Mr. Gefaller, still nothing to demonstrate the safety and efficacy of chiropractic for anything but low back pain. Eh? And no proof of chiro-subluxations nor Innate Intelligence?

Bearing in mind that spinal manipulation is not real chiropractic, but rather a technique that chiropractors have adopted, apparently to give themselves an air of legitimacy (see http://jmmtonline.com/documents/HomolaV14N2E.pdf ), it's worth noting that a responsible risk/benefit assessment for chiropractic spinal manipulation as an intervention for back pain is largely unfavourable - as explained in the following quote which is lifted from a critique of the recently released (UK) NICE guidelines for low back pain:

“…serious complications occur mostly (not exclusively) after upper spinal manipulation. So the guideline authors felt that they could be excluded. This assumes that a patient with lower back pain will not receive manipulations of the upper spine. This is clearly not always the case. Chiropractors view the spine as an entity. Where they diagnose ‘subluxations’, they will normally manipulate and ‘adjust’ them. And ‘subluxations’ will be diagnosed in the upper spine, even if the patient suffers from back pain. Thus many, if not most back pain patients receive upper spinal manipulations. It follows that the risks of this treatment should be included in any adequate risk assessment of spinal manipulation for back pain”.

Ref: Ernst, E. Spinal manipulation for the early management of persistent non-specific low back pain - a critique of the recent NICE guidelines, Int J Clin Pract, 18th August 2009. Reprints available from author.

In view of the above, perhaps it's not surprising that the most recent Systematic Review of Systematic Reviews of Spinal Manipulation (2006) concludes that there is no convincing evidence to suggest that spinal manipulation is a recommendable treatment option for any medical condition:http://www.jrsm.org/cgi/content/full/99/4/192

It seems to me that chiropractors should start thinking about calling it a day.

Manipulation is a biomedical intervention, used mainly for common musculoskeletal disorders by a wide range of healthcare practitioners, both within the banner of conventional medicine and outside it. Taken alone, it is like any other intervention for these conditions; it will work in some cases but not others. It is increasingly clear that no biomedical approach in isolation is adequate for common musculoskeletal conditions. The usefulness of manipulation is that it can be used within a package of care that provides advice about re-activation, reassurance about resuming activity, pain control, and the recognition and minimization of psychosocial risks for chronicity. The trials excluded by Ernst and Canters review (e.g., the UK BEAM trial)2,3 show that manipulation is effective and cost-effective within such a package of care. Current guidelines also recognize this.

Ernst has a record of publications that take a different approach4; and there is enough evidence about manipulation in the back pain area that further explanatory trials are probably no longer needed. Rather, as with many interventions including exercise, further research is needed to help clarify where it is best used in a package of care and for which patient subgroups; so that practitioners who have the training to use it can do so more selectively within a holistic approach.

We are extremely disappointed at the level of scientific reporting demonstrated by the Ernst and Canter paper on spinal manipulation (April 2006 JRSM1). As a result, this publication does not appear to add anything to the extensive knowledge base in this area. In our opinion, there are a number of significant flaws in their review which casts an extremely negative light on both authors of the publication and the journal review process.

How reliable are the conclusions?While this systematic review appears to have been well conducted, insufficient details of the methodological robustness of the reviews included in the systematic review were provided. In addition, few details relating to the quality or the results of the primary studies included in the original reviews were reported. As a consequence, the reliability of the authors' conclusions cannot be fully assessed.

We do, however, note that the absence of evidence is not the same as evidence of absence of an effect. None of the reviews conclusively demonstrates that SM is ineffective.

from the same article above

That’s true, but when you take into account a responsible risk/benefit assessment, it shows spinal manipulation, as performed by chiropractors, to be largely unfavourable when there are other equally effective, cheaper, more convenient, and safer options available.

Last edited by Blue_Wode on Wed Nov 18, 2009 8:23 pm, edited 1 time in total.

The trials excluded by Ernst and Canters review (e.g., the UK BEAM trial)2,3 show that manipulation is effective and cost-effective within such a package of care. Current guidelines also recognize this.

apparently there are some differences in opinion that were not mentioned by blue wode

Those comments made by Breen et al in response to Canter and Ernst’s systematic review of spinal manipulation elicited the following response from Canter and Ernst:

Several comments note that our conclusions are not in line with current guidelines. We also make this point in our article and suggest `... that these guidelines be reconsidered in the light of the best available data'.1 Surely this is sensible? Yet Breen et al. categorically state `... there is enough evidence about manipulation in the back pain area', providing no reference in support of this statement. One could therefore be forgiven for concluding that it is more the result of wishful thinking than of critical evaluation.

2. Did not include 23–26% of the study population[Tillett R. United Kingdom back pain exercise and manipulation(UK BEAM) trial. What happened to participants who were notincluded in the analysis? BMJ 2005; 330: 674.]

3. Had a design that couldn’t control for placebo and other non-specific effects.[Ernst E. United Kingdom back pain exercise and manipulation(UK BEAM) trial. Touch may have had non-specific effect, amongother things. BMJ 2005; 330: 673–4.]

BTW, here’s what Ernst has to say on the subject of chiropractic and guidelines:

And what about national guidelines? Chiropractors argue that their approach must be safe and effective, not least because the official guidelines on the treatment of back pain recommend using chiropractic. However, this is true only for some, but by no means all, countries.

Secondly, guidelines are well known to be influenced by the people who serve on the panel that develops them. Cochrane reviews, on the other hand, are generally considered to be objective and rigorous.

Writing about the importance of systematic reviews for health care in the Lancet, Sir Ian Chalmers stated, ‘I challenge decision makers within those spheres who continue to frustrate efforts to promote this form of research to come out from behind their closed doors and defend their attitudes and policies in public. There is now plenty of evidence to show how patients are suffering unnecessarily as a result of their persuasive influence.’

So, it would seem that, in many cases, current guidelines have been developed by panels of experts that are top-heavy with CAM proponents with vested interests (e.g., see here: http://www.dcscience.net/?p=1516 ).

Following on from the quote above, here’s a reminder of the conclusions reached by the most up-to-date Cochrane review of spinal manipulation for low-back pain:

This review of 39 trials found that spinal manipulation was more effective in reducing pain and improving the ability to perform everyday activities than sham (fake) therapy and therapies already known to be unhelpful. However, it was no more or less effective than medication for pain, physical therapy, exercises, back school or the care given by a general practitioner.

Returning to Alan Breen, DC, an academic who works at the Anglo European College of Chiropractic in the UK, and who serves on two of the UK chiropractic regulatory body’s committees - and who also served on the panel that developed the European Guidelines on low back pain - here’s a revealing, recent, blog post on him: http://evidencematters.org/2009/06/27/a ... democracy/

Last edited by Blue_Wode on Wed Nov 18, 2009 8:28 pm, edited 3 times in total.

We are extremely disappointed at the level of scientific reporting demonstrated by the Ernst and Canter paper on spinal manipulation (April 2006 JRSM1). As a result, this publication does not appear to add anything to the extensive knowledge base in this area. In our opinion, there are a number of significant flaws in their review which casts an extremely negative light on both authors of the publication and the journal review process.

This was Canter and Ernst’s response to the concerns of Byfield and McCarthy, some of which are noted in the quote above:

Today, 89.8% of (USA) chiropractors feel that spinal manipulation should not be limited to musculoskeletal conditions.3 It is thus not `methodologically unsound', as D Byfield and P McCarthy assume, but necessary to conduct a health technology assessment of spinal manipulations for the full range of conditions for which adequate data are available. Similarly, global assessments exist also in the chiropractic literature and are acclaimed by chiropractors—as long as they are not truly critical of their practice.4

Of course, Byfield and McCarthy are right, the majority of chiropractic patients suffer from musculoskeletal problems, but are they suggesting one must not ask questions about the rest? And, of course, the `straight' chiropractors adhering to Palmer's gospel are in the minority; but, in the UK, the influence of those `vitalists', who insist spinal manipulation is a panacea, is growing.5

It is not correct that we have `aggregated' different conditions. In fact, we assessed systematic reviews pertaining to different conditions quite separately.1 A systematic review is an accepted method for minimizing bias, the argument that our article maximized bias seems therefore illogical and has no basis. In this context it is worth noting that most of the commentators are affiliated with chiropractic or osteopathic organizations, while neither of us is on the payroll of an interested party.

Byfield and McCarthy's claim that our approach `lacks statistical validity' is embarrassing — we did not use any statistics in this paper. Systematic reviews inevitably require some inclusion/exclusion criteria. Thus, some articles will always be omitted which others would have liked to include—perhaps because of their favourable results. It is, however, misleading to imply that we systematically excluded studies of `manipulation as used in practice'. Most of the 16 evaluated reviews included such trials.

How reliable are the conclusions?While this systematic review appears to have been well conducted, insufficient details of the methodological robustness of the reviews included in the systematic review were provided. In addition, few details relating to the quality or the results of the primary studies included in the original reviews were reported. As a consequence, the reliability of the authors' conclusions cannot be fully assessed.

don't you just love when so called skeptics are pick and chose research to suit their own bias?

there appears to be alot of problems with the research quoted by blue wode

It would be interesting to know what the NHS had to say about Ernst’s systematic review of adverse effects of spinal manipulation which was published the following year (2007), and which reached the following conclusions:

…spinal manipulation, particularly when performed on the upper spine, has repeatedly been associated with serious adverse events. Currently the incidence of such events is unknown. Adherence to informed consent, which currently seems less than rigorous,75 should therefore be mandatory to all therapists using this treatment. Considering that spinal manipulation is used mostly for self-limiting conditions and that its effectiveness is not well established,5 we should adopt a cautious attitude towards using it in routine health care.

IMO, at the end of the day, even if the risk/benefit profile for spinal manipulation does turn out to be relatively safe (and that looks exceedingly slim), you still cannot escape the fact that spinal manipulative therapy is not chiropractic, but rather a technique that chiropractors have adopted.

We know that real chiropractic involves the detection of imaginary ‘subluxations’ which are supposedly corrected by administering ‘specific spinal adjustments’ to (allegedly) enhance a person’s health.

We also know that often chiropractors seem to confuse the two approaches, perhaps to give their practices an air of legitimacy, although many others will admit outright that traditional chiropractic beliefs are central to their interventions.

In view of the above, I really don’t see why there’s a need for chiropractors when what they do that is unique to them is outright quackery - and the very little that they can do that is evidence based is offered by other manual therapists who are much less mired in pseudoscience and therefore much more likely to apply their interventions judiciously.

Carmichael, CA - October 20, 2009 - A report, prepared by a global leader for trusted human resources and related financial advice, products and services, finds that the addition of chiropractic care for the treatment of low back and neck pain will likely increase value-for-dollar in US employer-sponsored health benefit plans. Authored by Niteesh Choudhry, MD, PhD, and Arnold Milstein, MD, the report can be fully downloaded at:

Low back and neck pain are extremely common conditions that consume large amounts of health care resources. Chiropractic care, including spinal manipulation and mobilization, are used by almost half of US patients with persistent back-pain seeking out this modality of treatment.

The peer-reviewed scientific literature evaluating the effectiveness of US chiropractic treatment for patients with back and neck pain suggests that these treatments are at least as effective as other widely used treatments. However, US cost-effectiveness studies have methodological limitations.

High quality randomized cost-effectiveness studies have to date only been performed in the European Union (EU). To model the EU study findings for US populations, researchers applied US insurer-payable unit price data from a large database of employer-sponsored health plans. The findings rest on the assumption that the relative difference in the cost-effectiveness of low back and neck pain treatment with and without chiropractic services are similar in the US and the EU.

The results of the researchers' analysis are as follows:

-Effectiveness: Chiropractic care is more effective than other modalities for treating low back and neck pain.

Cost-effectiveness: When considering effectiveness and cost together, chiropractic physician care for low back and neck pain is highly cost-effective, represents a good value in comparison to medical physician care and to widely accepted cost-effectiveness thresholds.

These findings, in combination with existing US studies published in peer-reviewed scientific journals, suggest that chiropractic care for the treatment of low back and neck pain is likely to achieve equal or better health outcomes at a cost that compares very favorable to most therapies that are routinely covered in US health benefits plans. As a result, the addition of chiropractic coverage for the treatment of low back and neck pain at prices typically payable in US employer-sponsored health benefit plans will likely increase value-for-dollar by improving clinical outcomes and either reducing total spending (neck pain) or increasing total spending (low back pain) by a smaller percentage than clinical outcomes improve.

the honorable opposition wrote:... in combination with existing US studies published in peer-reviewed scientific journals, ...

Why don't you point us to the high quality studies that compare chiropractic treatment for neck pain vs. safer treatments? You have just linked to a puff-piece that was designed to make chiro look good. I will see what is in that document.

Remember, chiropractic magazines are not adequately refereed and don't qualify as science.

Fraud laws are designed to test, evaluate and deal with fraudulent claims and practices. For many years, chiropractic has passed all of these tests. Snake oil and electric girdles have gone away. The fact that the medical profession doesn't happen to like the competition, doesn't make the fraud laws inadequate or the entire practice of chiropractic fraudulent.

Every year, many medical doctors are prosecuted for fraud, but that doesn't require us to outlaw the practice of medicine. The lynch mob may think the law is wrong, but that doesn't mean it is wrong.

The job of a skeptic is to investigate the unexplained; not to explain the uninvestigated.

landrew wrote:Fraud laws are designed to test, evaluate and deal with fraudulent claims and practices. For many years, chiropractic has passed all of these tests. Snake oil and electric girdles have gone away. The fact that the medical profession doesn't happen to like the competition, doesn't make the fraud laws inadequate or the entire practice of chiropractic fraudulent.

Every year, many medical doctors are prosecuted for fraud, but that doesn't require us to outlaw the practice of medicine. The lynch mob may think the law is wrong, but that doesn't mean it is wrong.

The chiropractic is based on magic, so it will eventually fail in court.

landrew wrote:Fraud laws are designed to test, evaluate and deal with fraudulent claims and practices. For many years, chiropractic has passed all of these tests. Snake oil and electric girdles have gone away. The fact that the medical profession doesn't happen to like the competition, doesn't make the fraud laws inadequate or the entire practice of chiropractic fraudulent.

Every year, many medical doctors are prosecuted for fraud, but that doesn't require us to outlaw the practice of medicine. The lynch mob may think the law is wrong, but that doesn't mean it is wrong.

The chiropractic is based on magic, so it will eventually fail in court.

Good. Then let's wait for the law to do it's job.

The job of a skeptic is to investigate the unexplained; not to explain the uninvestigated.

landrew wrote:Fraud laws are designed to test, evaluate and deal with fraudulent claims and practices. For many years, chiropractic has passed all of these tests. Snake oil and electric girdles have gone away. The fact that the medical profession doesn't happen to like the competition, doesn't make the fraud laws inadequate or the entire practice of chiropractic fraudulent.

Every year, many medical doctors are prosecuted for fraud, but that doesn't require us to outlaw the practice of medicine. The lynch mob may think the law is wrong, but that doesn't mean it is wrong.

The chiropractic is based on magic, so it will eventually fail in court.

Good. Then let's wait for the law to do it's job.

Oh, that's a good idea. The law makers are all honest and certainly not getting any money from the chiroquackters.

landrew wrote:Fraud laws are designed to test, evaluate and deal with fraudulent claims and practices. For many years, chiropractic has passed all of these tests. ...

First, legal trials are no place to examine scientific fraud since judges and juries are usually not competent in science. Second, tell us the trials that have addressed the fraudulent basis of chiro. Preston Long's book ("The Naked Chiropractor") documents many cases of chiropractors convicted of fraud; just not pertaining to the basic fraud of their cult.

Don't you get tired of pontificating in the absence of knowledge? I suppose the anonymity prevents you from being embarrassed.

Last edited by JJM on Thu Nov 26, 2009 7:05 pm, edited 1 time in total.

For readers who may be unaware, the Foundation for Chiropractic Progress (FCP) is a chiropractic marketing outfit. It recently received approximately $650,000 in pledges to help with its mission “To increase the public awareness of the benefits of chiropractic”: http://www.chiro.org/wordpress/?p=1151

That mission statement is worth noting in view of an article that was published in the 7th October 2009 issue of Dynamic Chiropractic which revealed that the Foundation for Chiropractic Evidence and Research (FCER) had decided on self-liquidation and filed for bankruptcy:http://www.dynamicchiropractic.com/mpac ... p?id=54144

...and it raises the following question; wouldn’t it be better for the FCP’s funds to be channelled into research rather than promotional activities? Or could it be that the research done by the FCER over the years has confirmed that the evidence for chiropractic is vanishingly slim, and, as a consequence, the chiropractic industry now has to depend heavily on dubious PR tactics - apparently aimed at people who aren’t well-versed in science - for its survival?

the honorable opposition wrote:The peer-reviewed scientific literature evaluating the effectiveness of US chiropractic treatment for patients with back and neck pain suggests that these treatments are at least as effective as other widely used treatments.

But, as we have already learned, they are not as safe. Besides, they don’t take into account the ‘bait and switch’ of unscientific medicine:

“Chiropractic is perhaps the most common and egregious example of the bait and switch in medicine…someone may go to see a chiropractor and think they will be seeing a medical professional who will treat their musculoskeletal symptoms, but in reality they will see the practitioner of a cult philosophy of energy healing…The bait – claims that chiropractors are medical practitioners with expertise in the musculoskeletal system. The switch – practitioners of discredited pseudosciences that have nothing to do with the musculoskeletal system…A more subtle form of the bait and switch among chiropractors is the treatment of musculoskeletal symptoms with standard physical therapy or sports medicine practices under the name of chiropractic manipulation. Ironically, the more honest and scientific practitioners among chiropractors are most likely to commit this subtle deception. The problem comes not from the treatment itself but the claim that such treatments are ‘chiropractic’… But by doing so and calling it ‘chiropractic’ it legitimizes the pseudoscientific practices that are very common within the profession – like treating non-existent ‘subluxations’ in order to free up the flow of innate intelligence.”

In view of all that has been posted on this thread (and I've read it all), it would seem the bottom line is that since other equally effective, more convenient, cheaper, and safer options are available, it would be unethical for chiropractors to administer any type of spinal manipulation/chiropractic adjustment to a patient unless that patient still consented to treatment after being informed of its evidence base, associated risks, and all other options available.

Further, if patients seek out chiropractors because conventional treatments have failed, it could easily be that such a course of action is, in most cases, simply serving as an expensive distraction whilst their ailments run their natural course. For example, a comparison of physical therapy, chiropractic manipulation, and the provision of an educational booklet for the treatment of patients with low back pain arrived at the following conclusion:

"…the McKenzie method of physical therapy and chiropractic manipulation had similar effects and costs, and patients receiving these treatments had only marginally better outcomes than those receiving the minimal intervention of an educational booklet. Whether the limited benefits of these treatments are worth the additional costs is open to question."

the honorable opposition wrote:... in combination with existing US studies published in peer-reviewed scientific journals, ...

Why don't you point us to the high quality studies that compare chiropractic treatment for neck pain vs. safer treatments? You have just linked to a puff-piece that was designed to make chiro look good. I will see what is in that document. ...

I am still waiting for the quality research supporting chiro in neck treatment. I found this that reviews such studies and finds them too be too poor quality to recommend neck snaps: http://www.bestbets.org/bets/bet.php?id=195

Comment(s) Virtually all of these studies are flawed and the numbers tiny. In particular there are no powerful studies comparing best conventional treatment with best alternative treatments. ...

Clinical Bottom Line Chiropractic therapy is associated with improvement in neck symptoms but there is no evidence to show whether this improvement is greater or worse than that obtained with conventional treatment.

I used to handle auto accident claims for State Farm Insurance, so I've had a lot of exposure to chiropractic medical records, and dealing with them in person (mostly on the phone, of course.)

One guy told me that the claimants back pain was definitely from the accident, even though it developed several months post event. I asked him how that was possible. He stated the body can "store injuries for months or even years before they become apparent." I then asked him if that was the case how could I relate this present problem to the accident and not something else that happened before or after. He complained to my boss that I was being "rude".

Might was well toss this into the mix: My aunt Ruth was being treated for "whiplash" by her chiro. She went three times a week for six months. On her last visit the 'doctor' discovered that she had broken her hip some time in the past and needed to be treated for that now. Evidently she had wrecked a major joint and hadn't even noticed. Another six months of treatment.

How can the above cases be considered anything other than fraud, please?

We recognize that acute illness and damage to the nervous system often give rise to pain acutely, and we expect that the pain will gradually subside. We also recognize that occasionally acute pain fails to subside, with the result that chronic pain ensues. Yet surprisingly, pain sometimes only develops a long time after the causative event and, equally surprisingly, even chronic pain can subside after a long time. What is a long time? Clearly a pain that develops or resolves 30 years after an insult is of late onset, but whether onset of pain after 10, 5 or 1 year, or 1 month, is `late onset' remains as arbitrary as defining post-herpetic neuralgia.

Not only are the temporal aspects very variable, but the manner in which late-onset pain develops or subsides is also very variable. Sometimes pain occurs suddenly, even within minutes, yet sometimes development takes place over weeks; similarly, freedom from pain can occur suddenly or gradually and may prove evanescent or long lasting, if not permanent.

http://brain.oxfordjournals.org/cgi/content/full/124/6/1067

delayed onset pain after trauma has been widely described in the literature

maybe your lack of knowledge on the subject is a reason why you an ex-employee of an insurance company

The crippling effects of bias and editorial policy of certain medical journals just discussed have ramifications in what is actually stated in papers and subsequently in the lay press. One study published in the New England Journal of Medicine (NEJM), for instance, stated a conclusion that was far beyond anything supported by the data. Specifically, the study discouraged the routine referral of patients to chiropractic: "Given the limited benefits and high costs, it seems unwise to refer patients with low back pain for chiropractic or McKenzie therapy." [27] As egregiously out-of-bounds as a statement such as this is for a scientific journal, the lay press (to which the NEJM reportedly controls half of what health news we hear) only made matters worse. Such scare headlines as "Study Targets Worth of Chiropractic" [36] and "Chiropractic Care Blasted in Two Studies" [37 ]only poisoned the atmosphere, inhibiting further research efforts and inducing third party payors to deny reimbursements for chiropractic services in which the outcomes have yet to be definitively disproved. News releases such as these need to be actively discouraged, and the public needs to be further enlightened as to the research and potential of multiple modes of alternative therapy—not just chiropractic.

We recognize that acute illness and damage to the nervous system often give rise to pain acutely, and we expect that the pain will gradually subside. We also recognize that occasionally acute pain fails to subside, with the result that chronic pain ensues. Yet surprisingly, pain sometimes only develops a long time after the causative event and, equally surprisingly, even chronic pain can subside after a long time. What is a long time? Clearly a pain that develops or resolves 30 years after an insult is of late onset, but whether onset of pain after 10, 5 or 1 year, or 1 month, is `late onset' remains as arbitrary as defining post-herpetic neuralgia.

Not only are the temporal aspects very variable, but the manner in which late-onset pain develops or subsides is also very variable. Sometimes pain occurs suddenly, even within minutes, yet sometimes development takes place over weeks; similarly, freedom from pain can occur suddenly or gradually and may prove evanescent or long lasting, if not permanent.

http://brain.oxfordjournals.org/cgi/content/full/124/6/1067

delayed onset pain after trauma has been widely described in the literature

maybe your lack of knowledge on the subject is a reason why you an ex-employee of an insurance company

So, a "full blown subluxation" can occur spontaneously after months or years? Really? My BS meter is pegging out here.

It was greed that took me away from that job. I got sick of people thinking they'd hit the pot of gold when somebody bumped them at 5 mph.